A patient who has had a massive heart attack faces a more than four-fold higher risk of death if doctors use drug-coated stents on him/her, compared to a patient who received the older stent (bare metal), according to research presented at the European Society of Cardiology Congress, Vienna, Austria. Philippe Gabrial Steg, who presented his team’s findings, said patients who have had a massive heart attack should not be given drug-eluting stents.

This is not the first time drug-eluting (drug-coated) stents have had unfavorable reports. In 2006 research indicated that there is a link between them and deadly blood clots.

Philippe Gabrial Steg and team monitored over 2000 patients who had suffered a heart attack for a period of 24 months after receiving either drug-eluting stents or bare-metal stents. They found that those who had received the drug-coated stents faced a risk of death 4.7 times higher, compared to patients who received the bare-metal stents.

Steg explained that heart attack patients are more vulnerable to the formation of clots in gaps that are produced when certain stents are placed in their narrower blood vessels – their blood vessels may not be suited to certain sizes of stents. Steg added that he no longer uses these stents on heart attack patients.

A Swedish study, on the other hand, also presented at the European Society of Cardiology Congress indicates that drug-eluting stents present no higher risk to patients than bare-metal stents.

What are Stents?

Stents are inserted during an angioplasty. A minuscule deflated balloon is positioned next to a clog, it is then inflated, thus flattening the clog, a tiny mesh scaffolding (stent) is placed in the area to keep the artery open. The stent stays in the artery permanently, holding it open and improving blood flow to the heart muscles – the patient generally feels relief (less or no more chest pain). A few weeks after the stent is placed the endothelium (inside lining of the artery) grows over the metal surface of the stent.

Doctors use stents depending on certain features of the artery blockage – the size of the artery and where the blockage is are both important factors. Today, about 70% of coronary angioplasty procedures include stenting.

What is a drug-eluting stent?

It is a stent that is coated with a medicine. The medicine is supposed to help prevent the artery from re-closing.

What is a bare-metal stent?

It is a stent that is not coated with a drug – just the pure scaffolding.

— European Society of Cardiology Congress
— News from the European Society of Cardiology Congress

Written by: Christian Nordqvist